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United States Department of Agriculture

Agricultural Research Service

Research Project: VITAMIN K: FOOD COMPOSITION, BIOAVAILABILITY AND IT'S ROLE IN HUMAN HEALTH

Location: Human Nutrition Research Center on Aging

Title: Calcium intake is not associated with increased coronary artery calcification: The Framingham Study

Authors
item Samelson, Elizabeth -
item Booth, Sarah -
item Fox, Caroline -
item Tucker, Katherine -
item Wang, Thomas -
item Hoffmann, Udo -
item Cupples, L Adrienne -
item O'Donnell, Christopher -
item Kiel, Douglas -

Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: October 1, 2012
Publication Date: December 1, 2012
Citation: Samelson, E.J., Booth, S.L., Fox, C.S., Tucker, K.L., Wang, T.J., Hoffmann, U., Cupples, L., O'Donnell, C.J., Kiel, D.P. 2012. Calcium intake is not associated with increased coronary artery calcification: The Framingham Studay. American Journal of Clinical Nutrition. 96(6):1274-1280.

Interpretive Summary: Adequate calcium intake is known to protect the skeleton. However, studies reporting adverse effects of calcium supplementation on vascular events have raised widespread concern. We assessed the association between calcium intake (from diet and supplements) and coronary artery calcification, a direct measure of atherosclerosis that predicts risk of heart disease independent of other risk factors. This was an observational study, in which 690 women and 588 men in the Framingham Offspring Study attended clinic visits and completed food frequency questionnaires in 1998-2001, and underwent computed tomography (CT) scans four years later. Average coronary artery calcification score was not associated with total calcium intake in either men or women after adjustment for demographic and health factors that also influence coronary artery calcification. Results were similar for dietary calcium as well as for calcium supplement use. Our study does not support the hypothesis that high calcium intake increases coronary artery calcification, an important measure of atherosclerosis burden. Evidence is not sufficient to modify current recommendations for calcium intake to protect skeletal health with respect to vascular calcification risk.

Technical Abstract: Adequate calcium intake is known to protect the skeleton. However, studies that have reported adverse effects of calcium supplementation on vascular events have raised widespread concern. We assessed the association between calcium intake (from diet and supplements) and coronary artery calcification, which is a measure of atherosclerosis that predicts risk of ischemic heart disease independent of other risk factors. This was an observational, prospective cohort study. Participants included 690 women and 588 men in the Framingham Offspring Study (mean age: 60 y; range: 36–83 y) who attended clinic visits and completed food-frequency questionnaires in 1998–2001 and underwent computed tomography scans 4 y later in 2002–2005. The mean age-adjusted coronary artery–calcification Agatston score decreased with increasing total calcium intake, and the trend was not significant after adjustment for age, body mass index (BMI), smoking, alcohol consumption, vitamin D–supplement use, energy intake, and, for women, menopause status and estrogen use. Multivariable adjusted mean Agatston scores were 2.36, 2.52, 2.16, and 2.39 (P-trend = 0.74) with an increasing quartile of total calcium intake in women and 4.32, 4.39, 4.19, and 4.37 (P-trend = 0.94) in men, respectively. Results were similar for dietary calcium and calcium supplement use. Our study does not support the hypothesis that high calcium intake increases coronary artery calcification, which is an important measure of atherosclerosis burden. The evidence is not sufficient to modify current recommendations for calcium intake to protect skeletal health with respect to vascular calcification risk.

Last Modified: 7/28/2014
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